Individual
KELLY FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
484 MAIN ST, WORCESTER, MA 01608-1893
(508) 831-9768
Mailing address
484 MAIN ST, WORCESTER, MA 01608-1893
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11390
MA
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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